Abstract
Background: Although morphologic, radiographic, and manometric features of achalasia have been well defined, it has not been established by careful retrospective analysis whether achalasia is a progressive disorder resulting in complete decompensation. Study Design: To verify the hypothesis that achalasia is a progressive disease, we retrospectively investigated manometric, radiographic, and symptomatic data in patients with achalasia. Sixty-three patients (36 women and 27 men) with a median age of 44 years (range 11 to 79 years) were evaluated. The duration of symptoms ranged from 1 to 442 months, with a median of 48 months. Patients were divided into four groups according to the duration of symptoms: 36 patients with less than 5 years, 11 with 5 to 10 years, 9 with 10 to 15 years, and 7 with 15 years or more. Results: Contraction pressures of the esophageal body decreased significantly at every level when the duration of symptoms increased (p <0.04). The percentage of simultaneous waves in the esophageal body rose as the duration of symptoms increased. All waves were synchronous in every patient who had had symptoms for more than 15 years. The maximal width of the esophageal body measured on esophagram became greater with an increase in the duration of symptoms, but this measurement did not reach statistical significance (p = 0.063). The tortuosity of the esophagus, measured by the maximal angle of the esophageal axis, was significantly greater in patients with a longer duration of symptoms (p <0.02). The type of symptoms was not associated with the duration of symptoms. Conclusions: Achalasia is a progressive disease, as verified by manometric and radiographic findings. The classification of esophageal motor function expressed by amplitude of contraction pressure and angle of tortuosity is objective and useful. Classification of achalasia by duration of symptoms may be important in treatment selection and effectiveness.
| Original language | English |
|---|---|
| Pages (from-to) | 158-163 |
| Number of pages | 6 |
| Journal | Journal of the American College of Surgeons |
| Volume | 189 |
| Issue number | 2 |
| DOIs | |
| State | Published - Aug 1999 |
Fingerprint
All Science Journal Classification (ASJC) codes
- Surgery
Cite this
Manometric and radiographic verification of esophageal body decompensation for patients with achalasia. / Shiino, Yutaka; Houghton, Scott G.; Filipi, Charles; Awad, Ziad T.; Tomonaga, Tetsuya; Marsh, Robert E.
In: Journal of the American College of Surgeons, Vol. 189, No. 2, 08.1999, p. 158-163.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Manometric and radiographic verification of esophageal body decompensation for patients with achalasia
AU - Shiino, Yutaka
AU - Houghton, Scott G.
AU - Filipi, Charles
AU - Awad, Ziad T.
AU - Tomonaga, Tetsuya
AU - Marsh, Robert E.
PY - 1999/8
Y1 - 1999/8
N2 - Background: Although morphologic, radiographic, and manometric features of achalasia have been well defined, it has not been established by careful retrospective analysis whether achalasia is a progressive disorder resulting in complete decompensation. Study Design: To verify the hypothesis that achalasia is a progressive disease, we retrospectively investigated manometric, radiographic, and symptomatic data in patients with achalasia. Sixty-three patients (36 women and 27 men) with a median age of 44 years (range 11 to 79 years) were evaluated. The duration of symptoms ranged from 1 to 442 months, with a median of 48 months. Patients were divided into four groups according to the duration of symptoms: 36 patients with less than 5 years, 11 with 5 to 10 years, 9 with 10 to 15 years, and 7 with 15 years or more. Results: Contraction pressures of the esophageal body decreased significantly at every level when the duration of symptoms increased (p <0.04). The percentage of simultaneous waves in the esophageal body rose as the duration of symptoms increased. All waves were synchronous in every patient who had had symptoms for more than 15 years. The maximal width of the esophageal body measured on esophagram became greater with an increase in the duration of symptoms, but this measurement did not reach statistical significance (p = 0.063). The tortuosity of the esophagus, measured by the maximal angle of the esophageal axis, was significantly greater in patients with a longer duration of symptoms (p <0.02). The type of symptoms was not associated with the duration of symptoms. Conclusions: Achalasia is a progressive disease, as verified by manometric and radiographic findings. The classification of esophageal motor function expressed by amplitude of contraction pressure and angle of tortuosity is objective and useful. Classification of achalasia by duration of symptoms may be important in treatment selection and effectiveness.
AB - Background: Although morphologic, radiographic, and manometric features of achalasia have been well defined, it has not been established by careful retrospective analysis whether achalasia is a progressive disorder resulting in complete decompensation. Study Design: To verify the hypothesis that achalasia is a progressive disease, we retrospectively investigated manometric, radiographic, and symptomatic data in patients with achalasia. Sixty-three patients (36 women and 27 men) with a median age of 44 years (range 11 to 79 years) were evaluated. The duration of symptoms ranged from 1 to 442 months, with a median of 48 months. Patients were divided into four groups according to the duration of symptoms: 36 patients with less than 5 years, 11 with 5 to 10 years, 9 with 10 to 15 years, and 7 with 15 years or more. Results: Contraction pressures of the esophageal body decreased significantly at every level when the duration of symptoms increased (p <0.04). The percentage of simultaneous waves in the esophageal body rose as the duration of symptoms increased. All waves were synchronous in every patient who had had symptoms for more than 15 years. The maximal width of the esophageal body measured on esophagram became greater with an increase in the duration of symptoms, but this measurement did not reach statistical significance (p = 0.063). The tortuosity of the esophagus, measured by the maximal angle of the esophageal axis, was significantly greater in patients with a longer duration of symptoms (p <0.02). The type of symptoms was not associated with the duration of symptoms. Conclusions: Achalasia is a progressive disease, as verified by manometric and radiographic findings. The classification of esophageal motor function expressed by amplitude of contraction pressure and angle of tortuosity is objective and useful. Classification of achalasia by duration of symptoms may be important in treatment selection and effectiveness.
UR - http://www.scopus.com/inward/record.url?scp=0032817608&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032817608&partnerID=8YFLogxK
U2 - 10.1016/S1072-7515(99)00091-5
DO - 10.1016/S1072-7515(99)00091-5
M3 - Article
VL - 189
SP - 158
EP - 163
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
SN - 1072-7515
IS - 2
ER -